Dialectical Behavior Therapy and Adult ADHD

At Cloud Counseling, Dialectical Behavior Therapy (DBT) is a core component of my approach to treating adult ADHD. Through years of experience, I’ve found DBT to be one of the most effective options available for alleviating the challenges and symptoms typically associated with ADHD—not just problems with attentiveness and planning, but with emotional responses, too.

However, DBT is often not well understood—it’s only been around for a few decades, and its principles can be confusing to those who haven’t experienced it first hand. With that in mind, let’s take a closer look at this form of therapy, with an emphasis on its relationship to mindfulness and its effectiveness at treating adult ADHD.
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History and Uses

Originally developed in the 1970s by Marsha Linehan to treat borderline personality disorder (BPD) and expanded in the decades since, Dialectical Behavior Therapy (DBT) is actually a type of Cognitive Behavioral Therapy (CBT). CBT is a form of psychotherapy that’s frequently applied to patients with anxiety and depression, and involves adjusting problematic patterns of thought and behavior.

DBT is dialectical because it incorporates two approaches to therapy that are, in a certain sense, opposed to one another: the ideas of acceptance and of change. Change is an important part of DBT—like other forms of cognitive behavioral therapy, DBT emphasizes recognizing harmful patterns of thinking and behavior and finding ways to adjust them.

But DBT is unique in its approach to acceptance—influenced by Zen Buddhist ideas concerning mindfulness and acceptance of one’s feelings and emotions, DBT often involves trying not to change the way we feel, choosing instead to accept our emotional experiences.

​Relationship with Buddhism and Mindfulness

For centuries, Zen Buddhists have practiced meditation with the goal of achieving greater mindfulness, or awareness of one’s experience of the present moment. For many patients with mental health problems, including adult ADHD, the natural reaction to unpleasant thoughts and feelings may be to push them from one’s consciousness.

But DBT, with its emphasis on mindfulness and acceptance, often employs an opposite approach: DBT therapists actually encourage their patients to accept and be aware of these thoughts and feelings, learning over time to resist the urge to change them. Over time, the patient recognizes patterns and triggers that relate to their own feelings, and may find the feelings become less intense as a result.

Treatment for Adult ADHD

Cloud Counseling approaches the treatment of adult ADHD through DBT and mindfulness-based techniques, informed by Lidia Zylowski’s The Mindfulness Prescription for Adult ADHD, along with other texts and studies. It may seem counterintuitive to treat attention problems with a type of therapy that requires awareness and concentration, but I’ve found mindfulness to be especially effective at improving the symptoms and behaviors associated with ADHD, including memory, motivation, and distractibility.

By incorporating mindfulness into therapy, I believe that patients with adult ADHD—and other problems stemming from ADHD—are much more likely to be successful in the long term.